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N Engl J Med ; 391(4): 334-342, 2024 Jul 25.
Article in English | MEDLINE | ID: mdl-39018528

ABSTRACT

KRAS gain-of-function mutations are frequently observed in sporadic arteriovenous malformations. The mechanisms underlying the progression of such KRAS-driven malformations are still incompletely understood, and no treatments for the condition are approved. Here, we show the effectiveness of sotorasib, a specific KRAS G12C inhibitor, in reducing the volume of vascular malformations and improving survival in two mouse models carrying a mosaic Kras G12C mutation. We then administered sotorasib to two adult patients with severe KRAS G12C-related arteriovenous malformations. Both patients had rapid reductions in symptoms and arteriovenous malformation size. Targeting KRAS G12C appears to be a promising therapeutic approach for patients with KRAS G12C-related vascular malformations. (Funded by the European Research Council and others.).


Subject(s)
Proto-Oncogene Proteins p21(ras) , Mice , Animals , Humans , Proto-Oncogene Proteins p21(ras)/genetics , Female , Male , Arteriovenous Malformations/genetics , Adult , Pyridines/therapeutic use , Disease Models, Animal , Mutation , Middle Aged , Gain of Function Mutation , Piperazines/therapeutic use , Pyrimidines
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